K42
Non-Billable

Umbilical hernia

Non-Billable / Non-Specific Code

What is Umbilical hernia?

ICD-10-CM K42 is the diagnosis code for Umbilical hernia. This code falls under the section "Hernia" within Chapter 11 — Diseases of the digestive system (K00-K95). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.

⛔ Excludes1

Coding Guidelines for K42

⛔ Type 1 Excludes (Never code together)

The following conditions should never be coded at the same time as K42. They are mutually exclusive:

  • omphalocele (Q79.2)

ICD-10-CM Code Hierarchy

Understanding where K42 sits in the ICD-10-CM classification helps ensure proper coding:

Current CodeK42 — Umbilical hernia
Sub-Codes (3)
Sub-Codes 3 entries
K42.0Umbilical hernia with obstruction, without gangreneBillableK42.1Umbilical hernia with gangreneBillableK42.9Umbilical hernia without obstruction or gangreneBillable
Related Codes

Frequently Asked Questions

Is K42 a billable ICD-10-CM code?

No, K42 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.

What does K42 mean?

K42 is the ICD-10-CM diagnosis code for "Umbilical hernia". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.

What section is K42 in?

K42 is located in Section K40-K46 — "Hernia" within Chapter 11 of the ICD-10-CM Tabular List.

What are the sub-codes of K42?

K42 has 3 sub-code(s) that provide more specific detail: K42.0, K42.1, K42.9.

When should I use K42?

Use K42 when the patients documented diagnosis matches "Umbilical hernia" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.

People Also Ask

What is the ICD-10 code for Umbilical hernia?

The ICD-10-CM code for Umbilical hernia is K42.

Can K42 be used for primary diagnosis?

No, K42 is non-billable. Use a more specific sub-code for primary diagnosis billing.

What chapter is K42 in?

K42 is in Chapter 11 of the ICD-10-CM Tabular List.

What conditions are excluded from K42?

Type 1 Excludes for K42 include: omphalocele (Q79.2).

Is K42 valid for 2026?

Yes, K42 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.

See Also

← PreviousK41.91Unilateral femoral hernia, without obstruction or gangrene, recurrentNext →K42.0Umbilical hernia with obstruction, without gangrene
Code Details
K42
Umbilical hernia
Non-Billable / Non-Specific Code
11 — Diseases of the digestive system (K00-K95)
K40-K46 — Hernia
2026 ICD-10-CM